Koko Tiatia

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

13389615-3102 Issued in UT

Practice address

4066 E Sunbury LN
Eagle Mountain, UT 84005-6333

Phone

(801) 361-8399

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1790699189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4066 E SUNBURY LN",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840056333",
            "telephone_number": "801-361-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4066 E SUNBURY LN",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840056333",
            "telephone_number": "801-361-8399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIATIA",
        "first_name": "KOKO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": "13389615-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student in an Organized Health Care Education/Training Program in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Student in an Organized Health Care Education/Training Program in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.